Sleep in the Military: Promoting Healthy Sleep among U.S. Servicemembers

Synopsis

Sleep disturbances are a common reaction to stress and are linked to a host of physical and mental health problems. Given the unprecedented demands placed on U.S. military forces since 2001, there has been growing concern about the prevalence and consequences of sleep problems for servicemembers. Sleep problems often follow a chronic course, persisting long after servicemembers return home from combat deployments, with consequences for their reintegration and the readiness and resiliency of the force. Therefore, it is critical to understand the role of sleep problems in servicemembers' health and functioning and the policies and programs available to promote healthy sleep. This report provides the first comprehensive review of sleep-related policies and programs across the U.S. Department of Defense (DoD), along with a set of actionable recommendations for DoD, commanders, researchers, and medical professionals who treat U.S. servicemembers. The two-year multimethod study also examined the rates and correlates of sleep problems among post-deployed servicemembers, finding negative effects on mental health, daytime impairment, and perceived operational readiness. The research reviewed evidence-based interventions to treat sleep disturbances among servicemembers and veterans and exposed several individual- and system-level barriers to achieving healthy sleep. Implementing evidence-based treatments is just one step toward improving sleep across the force; as the research recommendations highlight, it is equally important that policies and programs also focus on preventing sleep problems and their consequences.

Excerpt

Sleep is a vital health behavior, and lack of sleep is reliably and prospectively linked with a host of adverse mental and physical health outcomes, including an increased risk of depression, suicide, accidents and injuries, cardiovascular morbidity, and mortality. Research has shown that sleep problems are prevalent in military populations— particularly among servicemembers who have deployed to combat operations in Iraq and Afghanistan, which is perhaps not surprising, given that sleep problems are a common reaction to stress. Research further suggests that, for many servicemembers, sleep disturbances persist for months or even years after deployments have ended. Thus, it is critical to understand the individual- and system-level factors that contribute to the onset, persistence, and exacerbation of sleep problems, as well as the downstream consequences for servicemembers’ mental and physical health and operational readiness. However, no study to date has comprehensively examined the types of sleep problems servicemembers are experiencing, the programs available to servicemembers to promote healthy sleep and treat sleep disorders, or the policy-level factors that may contribute to servicemembers’ sleep health across the deployment cycle and specifically in the post-deployment period, when sleep problems may have lasting implications for servicemember resilience.

To address these gaps, a team of researchers from the RAND National Defense Research Institute conducted reviews of the peer-reviewed academic literature and military policies and programs related to sleep. The research team also drew on both quantitative and qualitative data sources, collecting primary data on sleep problems and behaviors from a large sample (N = 1,957) of servicemembers across all Service branches and components; conducting interviews with health policymakers and personnel who work in military medical, operational, and training settings across the U.S. Department of Defense (DoD); and convening a panel of experts in military sleep research and policy. This multimethod approach provided insights and recommendations regarding the prevalence and consequences of sleep problems in military settings, as well as available programs and policies related to sleep. The ultimate goal of this research was to identify promising policy options and best practices for DoD to mitigate the negative consequences of sleep problems and promote greater sleep health among servicemembers.